Ghrelin’s role in reproduction was first suggested by its wide expression in many human reproductive tissues including its immunohistochemical expression in the human ovary. Ghrelin expression is identified in the seminiferous tubuli of the interstitial Leyding and Sertoli cells in male testicles, whereas it is identified in the ovarian hilus interstitial cells and mature corpus lutea in females.It is postulated that ghrelin plays a local regulatory role in the male and female gonads. In females, Ghrelin acts centrally by suppressing hypothalamic GnRH release and GnRH-induced gonadotropin secretion by the pituitary; and in gonads it acts by increasing luteolytic factors such as PGF2 alfa, and ghrelin inhibiting estradiol and progesterone biosynthesis in granulose-lutein cells as well as granulosa cell (GC) proliferation.This potential regulatory effect on steroidogenesis and ovarian cellular function led to the hypothesis that ghrelin may mediate the relationship between metabolism and oocyte quality in addition to possible role in the regulation of embryo development in as the cleavage development before the six-cell stage of a preimplantation human embryo depends solely on maternally inherited material. Ghrelin levels can, therefore, be an indicator of an underlying pathology as in humans in states of chronic malnutrition such as anorexia nervosa, serum ghrelin levels may be increased, while in other conditions it could be associated with decreased ghrelin levels such as obesity and polycystic ovarian syndrome (PCOS).
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